The Industrial-strength Imaging Executive
by Curtis Kauffman-Pickelle
Today’s medical-imaging profession is definitely not for the fragile and weak-kneed among our colleagues. It is becoming increasingly clear that navigating the constant changes and challenges that face the practice of radiology today will be the ultimate test of tenacity, perseverance, and creativity. We’re in the playoffs now, and the game is moving to the big-time arena—where the margin for error is nil.
Finger in the Wind
by Cheryl Proval
Physicians are in a real bind as fee-for-service reimbursement falls under attack and alternative payment methods (such as bundling and capitation) gain traction in Washington, DC. As of June 18, Medicare Part B claims were being processed with the 21.3% cut mandated by the sustainable growth rate’s formula, and House Democrats demanded legislation on jobs before they would pass the Senate bill to reverse the cut.
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Keep Your Hospital Relationships Healthy: Strategies for Every Practice
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Randy Roat, CHBME, VP of Radiology, MMP, and George Ehrhardt, CPA, Director, Practice Management, MMP
Medical Management Professionals, Inc.
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RIS to the Rescue | Strategies for Driving Revenue, Productivity and Profitability
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Visage Imaging
The Economic Case for Patient-friendly Imaging
As the technology used for radiologic studies matures, providers and referrers are increasingly focused on providing patients with a friendlier imaging environment—with good reason, according to Tariq Gill, MD.
Health Care’s New Financial Outlook
A window of access to capital has opened for hospitals, according to Lisa Goldstein, because of the improvement in the debt markets seen over the past six to nine months.
Dissecting a Mantra: Doing More With Less
Whenever the economic aspects of business get tough, do more with less is a phrase heard everywhere.
Operating an Imaging-center Chain in the Postapocalyptic Era
It began with the DRA, and ever since, CMS and Congress have set upon outpatient imaging like dogs on a bone, culminating in a new round of cuts to the technical component contained in the health-reform law. As a result, operations at many outpatient-imaging organizations came into acute focus in 2005, and they continue to be scrutinized.
Business 101: Goal Setting and Strategic Planning
This article is the second installment in a four-part series on applying basic business concepts to radiology.
Employing a Differentiation Strategy
Attracting referrals is more crucial than ever for imaging-center operators who hope to see their facilities survive, and even thrive, in these difficult times
Price Transparency Gains Traction
Owing to a confluence of market forces, industry innovation, and government action, consumers in more than half of US states now have at least some ability to see procedure charges in advance.
The Reconsolidation of Imaging Centers
Significant market trends, over the past few years, have affected the competitive environment between hospitals and physician-owned freestanding imaging centers.
Lost in Transcription
Charge reconciliation—the practice of identifying procedures that have slipped through the cracks at some point in the charge process and billing for them to optimize revenue—is important for any medical group, but particularly critical for imaging.
Rescuing Retirement
If you are like many physicians, you are lamenting the losses to your retirement plan after the financial meltdown. You might have lost a substantial amount, and you might wonder how you can quickly regain the losses.
Financial Justification for Imaging Equipment
Claiming a share of the capital budget for imaging equipment is not always hard, but it certainly can seem overwhelming.
Imaging-center Valuation 2010: Post-reform Drivers
While the industry landscape has certainly changed significantly since Radiology Business Journal published my article on this subject three years ago, the primary factors that drive the desire to complete transactions and the valuations remain largely intact.
MIPPA Accreditation: 20 Months to Go
As the deadline inches closer, radiology providers around the country are scrambling to meet new CMS accreditation requirements for MRI, CT, and nuclear medicine.
Bariatric MRI: Challenges and Work-arounds
ThedaCare is Northeastern Wisconsin’s largest community-owned health system; its numerous radiology units strive to provide the highest-quality imaging to attract new referrals while simultaneously retaining hard-won existing business.
Finding Value in Imaging-center Valuations
After unprecedented growth over the past two decades, freestanding imaging providers have found the past few years challenging.
Wide-open MRI
Advances in the field strength of open-bore MRI systems are also opening new doors for imaging providers.
MRI: The Next Generation
MRI has come a long way since its inception, and it has yet to cease evolving. New developments continue to surface, bringing with them changes in radiology practice patterns and opportunities to bolster revenues by attracting new patient populations.
New Templates for Recession-resistant Marketing
Marketing radiology services can represent a significant challenge, particularly in an increasingly consumer-driven medical marketplace, where outreach to patients requires reconfiguring a familiar line of messaging.
Radiology Assistants: A User’s Guide
From May 2007 to January 2008, an Atlanta, Georgia-based radiologist signed and submitted thousands of reports in his name, with one major caveat—he didn’t review a single one.
Relationships Gone Wild
All across the country, in markets large and small, a drama once considered unimaginable is unfolding in ways that are shaking the confidence of many radiology practitioners and creating tension within the ranks of hospital administrators.
Preventing a MAC Attack: The Importance of Radiology Charge-capture Audits
The advent of Medicare administrative contractors has emphasized the importance of ensuring that charge capture is consistent and accurate for the professional and technical components of care.
Radiology Billing, CSI: Managing Individual Payor Contracts
At NYU Langone Medical Center (NYULMC), New York, New York, even though the radiology department’s billing office adheres to the principle of a cross-trained staff pool, it practices the explicit division of labor.
Strategies for Accommodating Self-pay Patients
As the ranks of the uninsured continue to grow, it is increasingly important for radiology practices to implement strategies for dealing with self-pay patients.
Asset Management for Imaging Reduces Waste
Scarce capital, these days, poses a serious threat to imaging enterprises hoping to see even modest growth.
Building Bridges
A strong physician referral base requires meticulous planning and follow-through
Managing the Revenue Cycle
In revenue-cycle management for the practice, imaging center, and radiology department, success is achieved through the relentless and ongoing pursuit of defined metrics, with all hands on deck
RSNA 2009: A Finger on the Pulse and An Eye to the Future
Attendees at this year’s meeting can look forward to perennial-favorite sessions designed to keep radiologists on the cutting edge of their specialty, as well as some new features added to broaden the gathering’s scope
Why Design Matters in Imaging
It’s design that can make patients choose one imaging provider over another, according to Morris A. Stein, FAIA, FACHA.
Finding Benchmarks for Imaging’s Operating Costs
The operational management of medical imaging is obviously a significant expense, yet it has rarely been studied. In 1999, 55% of imaging costs were spent on compensation.¹
Restructuring the Balance Sheet
If you are anything like me, you have had a few sleepless nights worrying about the future of the health-services industry.
The Impact of 320 Detector Rows: Aquilion ONE in the Pediatric Setting
The 320-detector CT scanner, recently implemented at Arkansas Children’s Hospital, has minimized dose requirements, reduced the need for sedation, and opened the door for future research
DR Done the Right Way
If service, patient safety, and profit weren’t incentives enough, now hospitals and imaging clinics have another inducement to go digital: the Obama administration’s federal health care stimulus plan, which stresses health care IT and electronic medical records.
Training Technologists to Smile
In many imaging offices, the reception staff is coached and scripted, and its members might even engage in role-playing exercises in order to create the best experience for patients.
Iterative Reconstruction: Ready for Its Close-up?
Enhanced image clarity, less noise, and half the radiation exposure for patients: sound good?
Taking Advantage of the Radiology Audit
A radiology provider should look at an audit as a strategic opportunity
Developing Innovative Customer-service Initiatives
It could be the smiling greeter who welcomes patients into the facility, or the glasses of lemon water and the tray of cookies keeping them company in the waiting room.
Accessing Capital in a Tight Credit Market
After weathering last fall’s fiscal catastrophe, many hospital CFOs now find themselves in Bert Zimmerli’s position.
Trademarking and Copyrighting: The Beginner’s Guide
An established health care consulting practice had been in business for several years.
The Hard Copier’s Dilemma
Along London’s celebrated avenue of high-end medical care, Harley Street, it’s not uncommon to see sights that would make any hardened veteran of the US health care system green with envy.
RBMA Attendees Debate Outsourced Billing
It is a question often pondered by practice managers and others overseeing the financial aspects of an imaging enterprise:
Emergence of Consumerism in Imaging
Hurried along by economic hard times, consumerism is making an impact on diagnostic imaging choices, and savvy practices are responding
Shared Services: A Strategy to Reduce Costs Without Compromising Patient Care
Do you remember medical imaging before PACS? There were images stored in different ways, in different places, at different times; images were lost, and images sat in stacks, waiting to be filed.
Beware the Zone of Indifference
In a span of one month in late 2008, the following four incidents were reported.
Maximizing MRI Throughput With Efficient Scheduling
As little as one extra MRI per day can generate more than an additional $200,000 in incremental revenue annually, but most imaging centers use crude scheduling systems that do not accurately present a center’s potential throughput.
Dealing With Health Plans Costs Physicians Billions
Two studies¹,² published in May 2009 in Health Affairs have drawn attention to the administrative costs that physicians endure in dealing with health plans.
Accreditation and Radiology
Accreditation is important to radiology providers not only in ensuring reimbursement eligibility and protecting turf
Managing Errors in Demographic/Clinical Information: Using Tracking Mechanisms
All insurance accounts fall into one of two groups: full resolution (at negotiated fees, where the credits only consist of cash, contract adjustment, and probable bad debt, if any patient balance cannot be collected) or full write-off (where the practice did not comply with a payor-based rule).
Radiology’s Tough Love
Last month, I discussed the need (and demand) for a culture and ethos of customer service within medical imaging practices, departments, and centers.
Opening Minds to Open MRI
How do you acquire the high–field-strength open MRI unit of your dreams in a tough economy?
Place Your Bets
Do you think that for-profit freestanding outpatient imaging is a phenomenon destined to go the way of Tyrannosaurus rex?
Back to the Future
In the publisher’s message for the inaugural issue of a new magazine.
Imaging JVs: Strategic Partners or Just One More Competitor?
Hospital-radiology group JVs are key to preserving and growing imaging market share, but failure to cement strong relationships and expectations from the start is a prescription for failure
The High Price of Low Payment
Prepare for sharp increases in diagnostic imaging costs if CMS prices practices and entrepreneurs out of the imaging center business
A Case Inquiry:Can RFID Help Reduce Costs in Medical Imaging?
An exploration of the use of RFID technology to manage contrast inventory in the hospital setting identified potential cost savings, as well as implications for patient safety, inventory management, and billing
Smart Marketing in a Sick Economy
A recent statement from Moody’s Investors Service, New York, indicates that the health care sector in the United States.
Managing by Benchmarks: Making the Case for Accountability
Benchmarks enable managers to gain knowledge of their organizations and build a culture of accountability
Good Vibrations: Ultrasound Elastography
In February, France’s state-operated agency for the funding of innovation awarded a research-and-development grant worth 8.5 million euros to a European company that wants to validate a new application clinically for the still-nascent modality of ultrasound elastography.
The Weakening Economy and Health Care Collections
One of the overlooked consequences of the current economic uncertainty is the effect on health care collections.
RSNA 2008: Mining the Landscape, Assessing the Exhibits
In assessing the imaging technologies on display at RSNA, an observer provides tools for making critical decisions regarding your capital budget for 2009
Highly Functional Imaging
Great leadership will distinguish winning imaging organizations from those that struggle
CCTA Staffing and Coverage
Radiology practices and departments that intend to offer coronary CT angiography (CCTA) need to consider how the additional exam volume and time commitments created by CCTA studies will affect their operations and their staffing models.
The Sales-continuum Approach to Marketing ROI
In today’s challenging business environment, not many people would buy into the philosophy, in operating an imaging center, that if you build it, they will come.
The Purchasing Paradox
There is so much breadth and depth to today’s imaging marketplace that many radiology centers find themselves struggling to make sense of it all.
A First-to-market Approach in Charleston
Imaging Specialists of Charleston opened its doors at a time when most imaging centers were looking for ways to cut costs-and the South Carolina center took an aggressive first-to-market approach.
Reform’s Caveat Emptor
In 2009, we find ourselves in more than just another new year.
Due Diligence in Vendor Selection: Laying the Groundwork for a Strong Relationship
The first installment in this series described the process of evaluating your current vendor relationships to determine which of your concerns are not being met.
Advisory Opinion Muddies the Waters on Preauthorization
After reviewing a proposed arrangement pursuant to which a company would handle the processing and submission of insurance preauthorizations for various imaging services for the benefit of multiple imaging centers.
Using Adjustment Coding to Manage Practice Compliance
The October 2008 ImagingBiz.com article Keep Payors Honest With the Practice Receivable System concentrated on advanced techniques for monitoring the insurance companies that compensate radiologists for their clinical services.
Top 10 Control Items for Managing Practice Financials
You have, no doubt, heard the story about the quiet, loyal employee with many years of service to the business who one day sends his boss a postcard from Rio de Janiero, saying that he’s not coming back.
Bread Lines and Cab Lines
I’ll admit it. The constant drumbeat of depressing news in the business and popular press about the downturn in the world economy had me spooked as I traveled to the RSNA last week.
Changing Vendors: Costly Mistake or Wise Move?
Vendor relationships can be tough, and many end in a heap of disappointments, unfulfilled expectations, and miscommunications.
The Ultimate Road Trip
Just in time, radiology providers are arriving at an understanding of their unique branding propositions.
On the Good Ship RBJ
What a year—what a breathless, heart-stopping, devastating, and hopeful year this has been for just about everyone I know, including all of us here at The Imaging Center Institute, publisher of Radiology Business Journal.
The Excellence Formula
Radiology group practices can take the following seven steps to transform their practice models into something much closer to the ideal.
Historical Review of Mergers and Acquisitions in Diagnostic Imaging
From the go-go years to the present, acquisition strategies in the outpatient diagnostic imaging field have not always worked
ICD-10 Mandate to Break Physicians’ Bank
The typical 10-physician practice will spend $285,240 to comply the new federal mandate to adopt the ICD-10 code set by 2011.
The Usual Suspects
As I read the cover story on radiology benefit managers (RBMs) in this month’s Diagnostic Imaging (DI) magazine.
Retail Metrics: Opportunity Knocks Every Time the Threshold Darkens
When a customer walks in the door, Mark Schulein sees opportunities.
Negotiating for Better Reimbursement
Negotiating higher reimbursement is nearly always possible, according to Penny Noyes, president and CEO, Health Business Navigators, Bowling Green, Ky.
Keep Payors Honest With the Practice Receivable System
It is not a completely fair analogy, but the differing agendas of payors and providers place receivable processing in something of a battle zone.
Imaging’s Déjá-vu Moment
My conversation with a prominent radiologist was startling, even as it piqued my journalistic interest.
ACR Unveils a Modular MRI Accreditation Process
The ACR is set to launch a new modular MRI accreditation program designed to meet the specific practice patterns of individual facilities.
Increasing CT Productivity: Good for Patients, Referring Physicians, and the Bottom Line
CT has become indispensable tool for physicians to use in diagnosing and managing a vast array of medical conditions.
ICD-10 Deadline Brings on IT Headaches
No sooner did CMS call for an October 1, 2011, compliance date for the switch from ICD-9 to ICD-10 codes than a hue and cry arose from the health care industry, claiming that the change comes too soon.
Magical Thinking Obscures the Goal: Improved Outcomes
High hopes have been pinned on the potential of IT to improve health care delivery here and around the world.
Radiologist, Find Your Voice
In a major front-page story, “The High Cost of Precision,” in its Sunday, September 7, 2008 edition, the Los Angeles Times once again focused on the negative side of CT technology.
Florida Hold’em
In the show down between Florida Hospital and Florida Radiology Associates, the winner took all
The New Economics of Contrast
Not too long ago, prices for contrast media could get a radiology director’s pulse racing.
Physicians and the E Word
Physicians are understandably suspicious of efficiency efforts in medicine, but nowhere in the Hippocratic oath are they absolved from addressing the appropriate delivery of care
The Good, the Bad, and the Inspired
Finally, some good news for imaging.
Financial Adventures in Imaging, Post DRA
It’s been a year and a half since the debut of the DRA imaging cuts, and the dust is beginning to settle in the outpatient imaging market, according to Douglas Lynch.
Collecting Self-pay Balances: Cash Is King
You cannot pick up a newspaper today without reading about the 47 million uninsured US residents. Well, that is only the tip of the iceberg.
Operating Radiology As an Individual Business Unit
Both hospitals and imaging centers are struggling with economic and political pressures that are straining their relationships with staff; finance (administration/owners); radiologists; vendors (IT providers, equipment manufacturers, suppliers, and consultants); referring physicians; and the community (your patients).
What’s With the Attitude?
At least half of the elements of various success formulas, in business and in life, relate to one’s ability to keep a positive outlook—especially when circumstances make it most difficult to do so.
In Search of Web-site Optimization
In 1998, Jakob Nielsen, PhD, hailed by the New York Times as the guru of Web-page usability, wrote, “The Web is simply not that suited for advertising.”¹
Do Market Opportunities Remain in Outpatient Imaging?
In the post-Deficit Reduction Act (DRA) era, many current and would-be imaging providers are left with the same fundamental and related questions.
Game Plan for New Leaders
IN THE FEBRUARY 2008 ISSUE OF THE Harvard Business Review, Gott fredson et al1 look at the role of the incoming CEO or general manager.
What’s the Deal? A Look at Current Recruiting Packages in Radiology
As most markets are, the job market for physicians is fluid and is subject to shifts that can be either gradual or abrupt.
Growing Old Together
A lesson in business maturity: Microsoft CEO Steve Ballmer met the company’s cofounder Bill Gates when they were both undergraduates at Harvard.
Contract Negotiations: Not Just About the Dollars
Contract negotiations with payors formerly were a lengthy process. Not any more; they are concluded now in half the time because payors have stopped telling radiology groups to take it or leave it and, instead, are simply saying, “Take it.”
